INTERNSHIP AGREEMENT
CAREER DEVELOPMENT COORDINATOR:
Karen Darrow, MA, PHR
777 Grandview Drive
Kalispell, MT 59901
www.fvcc.edu
Office: 406.756.3900
FAX: 406.756.3911
Email: kdarrow@fvcc.edu
Instructions: Please complete the information below, save the file, then print & sign. An original, signed Internship Agreement must be received and
approved by the Career Development Coordinator prior to the start date. Internship Providers will be mailed a copy along with a letter of confirmation.
The signed agreement is uploaded into D2L for student and instructor viewing.
Semester(circle) FA SP SU 20___
Internship
Provider
Mentor/Title
Mentor #2
Address
Student
Intern
Intern Position
Address
City, State, Zip
Phone /
Cell
City, State, Zip
Phone /
Cell
FAX
Email
Registered as Employer in CONNECT
and entered internship/job description
☐ Yes - required
FAX
Email
Course#/
Instructor
Advisor
Registered
CONNECT
Total
Credits/
Hours
Schedule
(or attach)
Compensation:
Paid
Wage $_________/hour
☐ Unpaid (provider verifies internship
meets Fair Labor Standards criteria.
See attached)
Required
Begin Date:
End Date:
Or last day of
semester
Your signature below means you have read the respective INTERNSHIP HANDBOOK either in print or listed online at
http://www.fvcc.edu/current-students/student-resources/learning-center/career-services/internships/internship-forms.html and agree to
abide by and fulfill the ROLES & RESPONSIBILITIES therein. Please verify with your initials on page 2 of this AGREEMENT. This
AGREEMENT is in effect only from the Begin Date – End Date. The college or business/organization retains the right to terminate this
agreement should any party fail to meet the obligations outlined under their respective Roles and Responsibilities.
Internship Site Mentor: (Type or Print Name)
Date:
Signature:
Intern/Student: (Type or Print Name)
Signature:
Date:
Faculty/Instructor: (Type or Print Name)
Signature:
Date:
Career Development Coordinator: Karen Darrow
Signature:
Date:
FVCC DOES NOT DISCRIMINATE ON THE BASIS OF RACE, COLOR, NATIONAL ORIGIN, SEX, AGE, OR HANDICAP IN ADMISSION OR ACCESS
TO, OR TREATMENT OR EMPLOYMENT IN, EDUCATIONAL PROGRAMS OR ACTIVITIES. Inquiries concerning Title VI, IX and Section 504 may be
referred to the Vice President of Instruction & Student Services; Blake Hall, Rm. 137; 777 Grandview Drive; Kalispell, MT 59901; 406-756-3362; or the
Montana Human Rights Commission; 1236 Sixth Avenue; P.O. Box 1728; Helena, MT 59624; 406-444-2884 /1-800--542-0807.
Original received with all initials and signatures by ______________ on __________________.
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INTERNSHIP ROLES & RESPONSIBLITIES
STUDENT
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Meet pre-requisites noted in catalog, complete INTERNSHIP APPLICATION, with attachments --resume, references and site list.
Register for the course – paper form –signatures from advisor and the Career Development Coordinator [CCD] are required.
Attend an orientation to review syllabus, learn the internship process, and prepare application materials.
Meet with Career Development Coordinator to review application, resume and discuss potential internship sites.
Apply for and interview with prospective internship sites. If accepted, complete and return a signed INTERNSHIP AGREEMENT.
Note: No hours will be counted until a signed INTERNSHIP AGREEMENT is received by the CDC.
Consult with the Internship Site Supervisor and then meet with the Internship Faculty to review and develop specific, measurable and
relevant LEARNING OBJECTIVES, due within the first 20 hours of the internship.
Adhere to company policies, confidentiality, procedures and follow a pre-determined internship schedule that allows for completion of
required hours by the end of the semester.
Turn in, on time, course assignments including activity logs, time sheets, evaluations and documentation of learning as requested by
faculty/instructor.
Turn in MONTHLY TIME SHEETS to faculty/instructor by the 5th of the following month.
Authorize release of school records and other records in connection with the internship in compliance with FERPA.
Follow professional standards of conduct, organizational policies and safety standards. Violations of professional ethics,
insubordination, unexcused absences, breaches of confidentiality, or failure to turn in assignments on a timely basis are cause for
termination, removal from the internship site and will result in an “F” grade.
Share any concerns with the Faculty/Instructor and/or Career Development Coordinator.
Report any accidents to the worksite supervisor immediately; notify FVCC’s Business Services office at 756-3821.
Student Initials
_____
Date
__________
INTERNSHIP SITE
 Verify the ability of the business to provide meaningful mentoring and opportunities for intern learning and practicing their skills.
 Assure that the students will be accepted and assigned work without regard to age, handicap, national origin, race, marital status, parental
status, religion, or sex.
o Provide adequate working space, training, supplies and equipment for student training and learning.
o Train and orient student to all health and safety practices and organizational policies and procedures, including confidentiality,
applicable to the internship.
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Complete an internship listing that includes learning opportunities, project tasks, and minimum qualifications.
o Enter positions into the FVCC online job board CONNECT.
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Read and discuss the responsibilities, legal issues and learning components of internship with the Career Development Coordinator.
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Review resumes and interview prospective interns and inform interns & Career Development Coordinator of hiring decisions.
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Provide input to student in developing specific learning objectives, then provide assistance and training necessary to help student meet
those learning objectives, along with training to learn job specific skills.
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Establish a regular meeting time and meet with intern at least weekly to provide training, direction and feedback to the student.
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Participate in an on-site visit from internship Faculty/Instructor and assess student learning by verifying hours and completing and
returning a MID-TERM and FINAL INTERNSHIP PROVIDER EVALUATIONS noting accomplishment of learning objectives.
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Contact the FVCC instructor or Career Development Coordinator if any questions or problems arise.
Internship Site Mentor Initials _____
Date
___________
FVCC FACULTY/INSTRUCTOR
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Advise and assist the student in the development of clear, concise, measurable learning objectives.
Provide the student with a course syllabus and grade the student at the end of the term.
Coordinate the related instruction with the student’s curriculum and monitor the student’s internship experience through activity logs or
journals or discussions and track hours. Turn in MONTHLY TIME SHEETS from all students to CDC by the 5th of the month.
Meet with the student, in person, at least two times during the term, at least once at the work site.
Contact the internship site mentor at least twice during the term, one of which must be in person at the internship site.
Assist students and internship providers in meeting learning objectives and evaluating progress.
Instructor/Faculty Initials _____
Date
___________
FVCC CAREER DEVELOPMENT COORDINATOR
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Provide businesses, faculty and students with information about FVCC Internship opportunities, policies and procedures through
written and electronic materials, web pages or in person.
Discuss opportunities for learning and relevance of job description to major, degree area and intern’s career goals with potential
internship sites.
Ensure that internship site has adequate resources – work space, training time, and mentoring to enable the student to complete their
learning objectives in an environment conducive to learning.
Review legal guidelines re compensation, employment status, workers compensation and other employment laws with prospective
internship sites.
Maintain internship listings, database and provide assistance to help students locate internship sites with quality learning opportunities.
Career Development Coordinator Initials _____
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